Assessment of chitosan-based adsorbents for glyphosate removal.

Exposure to glyphosate produces various toxic effects, due to this, different methods have been evaluated for its elimination. The objective of this work was to formulate chitosan-based adsorbents and evaluate their efficiency in the removal of glyphosate in vitro. Four films were made by varying the weight ratio of silica/chitosan particles, and four sponges were made by varying the chitosan/chitosan ratio in a reticulated manner. Both adsorbents were characterized based on their porosity, water absorption, glyphosate removal, and reusability. It was found that increasing the porosity in both films and sponges resulted in an increase in the adsorption efficiency of glyphosate. The adsorption process exhibited a better fit in both adsorbents to the pseudo-second-order model. The adsorption of glyphosate to the films fit better with the Langmuir model, demonstrating that the process occurs in the form of a monolayer. In the case of sponges, the adsorption of glyphosate fit better with the Freundlich model, indicating that the process takes place in a multilayer form. Finally, when the reusability was evaluated, the adsorbents showed a loss of effectiveness. However, they still proved to be an efficient alternative for the removal of glyphosate in water, providing a cost-effective and environmentally friendly solution.

Anatomy and Design of Musculocutaneous Flaps in Nasal Reconstruction. / Anatomía y diseño de colgajos musculocutáneos en reconstrucción nasal.

The nose is a common site for skin tumors. The main arteries that supply the nose extend through the subcutaneous tissue. Submuscular dissection facilitates the design of safe, reliable musculocutaneous flaps that adapt well to the morphology of nasal defects. The diversity of these flaps makes them the first choice for reconstructing defects in more complex regions, such as the inner canthus of the eye and the nasal ala. We describe the surgical design of the procerus, V-Y nasalis, and lateral wall nasalis musculocutaneous flaps used to repair defects following tumor excision. The descriptions are illustrated by photographs taken by the authors during procedures and in cadaveric dissections.

Type 2 Diabetes and all-cause mortality among Spanish women with breast cancer.

PURPOSE: To explore the effect of type 2 diabetes mellitus (T2DM) on the risk of death among women with breast cancer (BC). METHODS: A survival analysis was conducted among a cohort of women diagnosed with BC between 2006 and 2012 in Spain (n = 4,493). Biopsy or surgery confirmed BC cases were identified through the state population-based cancer registry with information on patients' characteristics and vital status. Physician-diagnosed T2DM was confirmed based on primary health care clinical history. Cox regression analyses were used to estimate adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for all-cause death. Analyses were adjusted for age, hospital size, several clinical characteristics (including BC stage and histology, among others) and treatment modalities. RESULTS: Among the 4,493 BC women, 388 (8.6%) had coexisting T2DM. Overall, 1,299 (28.9%) BC women died during the completion of the follow-up and 785 (17.5%) did so during the first five years after BC diagnosis, resulting in a five-year survival rate of 82.5%. The death rate was higher in women with T2DM (43.8% died during whole period and 26.0% during the first five years) when compared with women without T2DM (27.5% and 16.7%, respectively). Accordingly, all-cause mortality was higher in women with T2DM (aHR: 1.22; 95% CI 1.03-1.44), especially if T2DM was diagnosed before BC (aHR:1.24; 95% CI 1.03-1.50) and in women with BC diagnosed before 50 years (aHR: 2.38; 95% CI 1.04-5.48). CONCLUSIONS: T2DM was associated with higher all-cause mortality among Spanish women with BC, particularly when the T2DM diagnosis was prior to the BC.

Insulin resistance in non-diabetes patients with spondyloarthritis.

Objectives: Insulin resistance (IR) constitutes a major underlying abnormality driving cardiovascular disease in the general population and has been linked to inflammatory diseases. In this study, we aimed to determine the prevalence of IR in patients with spondyloarthritis (SpA) and whether IR can be explained by disease-related features in such cases. Method: The study included 577 subjects: 306 patients diagnosed with SpA according to Assessment of SpondyloArthritis international Society criteria and 271 controls. Insulin and C-peptide serum levels, IR and ß-cell function (%B) indices by homoeostatic model assessment (HOMA2), and lipid profiles were assessed in patients and controls. A multivariable regression analysis was performed to evaluate the differences in IR indices between patients and controls and to determine how IR is associated with disease-related characteristics in SpA patients. Results: HOMA2-%B and HOMA2-IR scores, both calculated with insulin or C-peptide, had significantly higher values in SpA patients compared to controls in multivariable analysis adjusted for age, gender, traditional IR-related factors, and glucocorticoid intake. Disease activity, functional status, and metrological SpA indices were positively related to IR, but only in univariable analysis. Disease duration and positivity for human leucocyte antigen-B27 were independently associated with a higher HOMA2-%B after multivariable analysis. Conclusion: Patients with SpA have an increased IR compared to controls. SpA disease-related data are independently associated with ß-cell dysfunction.

Personalized medicine begins with the phenotype: identifying antipsychotic response phenotypes in a first-episode psychosis cohort.

AIMS: Here, we present a clustering strategy to identify phenotypes of antipsychotic (AP) response by using longitudinal data from patients presenting first-episode psychosis (FEP). METHOD: One hundred and ninety FEP with complete data were selected from the PEPs project. The efficacy was assessed using total PANSS, and adverse effects using total UKU, during one-year follow-up. We used the Klm3D method to cluster longitudinal data. RESULTS: We identified four clusters: cluster A, drug not toxic and beneficial; cluster B, drug beneficial but toxic; cluster C, drug neither toxic nor beneficial; and cluster D, drug toxic and not beneficial. These groups significantly differ in baseline demographics, clinical, and neuropsychological characteristics (PAS, total PANSS, DUP, insight, pIQ, age of onset, cocaine use and family history of mental illness). CONCLUSIONS: The results presented here allow the identification of phenotypes of AP response that differ in well-known simple and classic clinical variables opening the door to clinical prediction and application of personalized medicine.

Spanish Guidelines for Diagnosis, Management, Treatment, and Prevention of DRESS Syndrome.

BACKGROUND AND OBJECTIVE: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a complex multisystemic severe drug hypersensitivity reaction whose diagnosis and management are troublesome. DRESS syndrome requires management by various specialists. The correct identification of the culprit drug is essential to ensure safe future therapeutic options for the patient. There are no previous Spanish guidelines or consensus statements on DRESS syndrome. Objective: To draft a review and guidelines on the clinical diagnosis, allergy work-up, management, treatment, and prevention of DRESS syndrome in light of currently available scientific evidence and the experience of experts from multiple disciplines. METHODS: These guidelines were drafted by a panel of allergy specialists from the Drug Allergy Committee of the Spanish Society of Allergy and Clinical Immunology (SEAIC), together with other medical specialists involved in the management of DRESS syndrome and researchers from the PIELenRed consortium. A review was conducted of scientific papers on DRESS syndrome, and the expert panel evaluated the quality of the evidence of the literature and provided grades of recommendation. Whenever evidence was lacking, a consensus was reached among the experts. RESULTS: The first Spanish guidelines on DRESS syndrome are now being published. Important aspects have been addressed, including practical recommendations about clinical diagnosis, identification of the culprit drug through the Spanish pharmacovigilance system algorithm, and the allergy work-up. Recommendations are provided on management, treatment, and prevention. Algorithms for the management of DRESS in the acute and recovery phases have been drawn up. Expert consensus-based stepwise guidelines for the management and treatment of DRESS syndrome are provided.

Transport and concentration of wealth: Modeling an amenities-based-theory.

We derive a reaction-advection-diffusion equation based framework for analyzing the movement of wealth in urban environments. Gentrification is a core issue that affects many urban areas, and the dynamics of such are not fully understood. To understand the process using a few physically relevant variables, we develop an approach to model the interplay between local amenities and wealth from existing analyses of factors influencing gentrification. We conduct a linear stability analysis on model parameters that results in spatially homogeneous solutions and determine directions for parameter changes to induce instabilities. From these parameters, we determine quantities that lead to the formation of areas of wealth and amenity concentration in the long term on bounded and unbounded domains. We present a global bifurcation result in two dimensions, leading to the existence and stability of non-constant equilibrium solutions, which represents solutions with wealth and amenity hotspots. Finally, we present a theory for discerning the one-dimensional pattern formation in the transition between stability and instability and verify numerically through a weakly nonlinear analysis. The analysis provides a promising framework for further verification using publicly available geospatial data on the relevant variables.

Prevalence and caries-related risk factors in schoolchildren of 12- and 15-year-old: a cross-sectional study.

BACKGROUND: To assess the prevalence and severity of caries in 12- and 15-year-old schoolchildren, and to analyse the related risk factors. METHODS: We conducted a cross-sectional study on a random sample of 1843 schoolchildren aged 12 and 15 from Galicia (northwest of Spain). Self-administered questionnaire and dental clinical examination were performed to obtain information about oral health habits, dental caries and oral hygiene. A logistic regression model including dental-caries-related variables was generated for each age group. RESULTS: The respective findings for 12- and 15-years-old were as follows: decayed, missing, filled teeth index both for permanent and temporary dentition (DMFT/dmft) of 0.89 (95% CI, 0.87-0.91) and 1.38 (95% CI, 1.33-1.43), respectively; caries prevalence 39.6% (95% CI, 36.3-42.9) and 51.7% (95% CI, 48.0-55.4), respectively. In the 12-year-old group, individuals who occasionally, never or hardly ever brushed their teeth had higher values of caries (OR = 1.83, 95% CI 1.07-3.15, and OR = 9.14, 95% CI1.63-51.17, respectively). Also, the presence of plaque on more than 1/3 gingival was statistically associated with an increase of caries (OR = 2.03; 95% CI, 1.11-3.70), and living in a rural environment was a risk factor (OR = 1.3; 95% CI,1.02-1.80). In the 15-year-old group, higher caries risk was found when brushing was performed once a day (OR = 1.61; 95% CI,1.03-2.50), and among individuals who visited private clinics (OR = 1.77; 95% CI, 1.17-2.66), while electric toothbrush was associated with a lower caries risk (OR = 0.50; 95% CI, 0.29-0.86). CONCLUSIONS: This study revealed that risk factors of dental caries showed differences in schoolchildren of 12- and 15-year-old. Strongest evidence related to caries in 12-year-old group were found in frequency of toothbrushing and dental plaque. In 15-year old group, electric toothbrush, time since the last visit to the dentist and type of dental care (public/private) had a stronger association with dental caries. Caries prevalence and mean DMFT/dmft increased from 12- to 15-year-old, in spite of improvement in oral hygiene at the age of 15.

Clinical repercussions and epidemiological considerations of supernumerary canines: A 26 case series.

BACKGROUND: To establish the prevalence of supernumerary canines (SNC) in a sector of the population of Madrid (Spain), as well possible complications associated with this unusual developmental variation. STUDY DESIGN: This observational study was performed between 2005 and 2017, among 21,615 patients seeking dental treatment at the Faculty of Dentistry, Complutense University of Madrid (Spain), and at the Virgen de la Paloma Hospital, Madrid (Spain); 22 patients with 26 SNCs were diagnosed. These 22 patients underwent clinical and radiological exploration, registering patient data. RESULTS: SNCs presented a prevalence of 0.10% of the study population. The supernumerary teeth (SNT) were located in the upper maxilla more frequently (61.54%) than the mandible (38.46%). 69.23% were found to be impacted, also causing the impaction of the permanent canine in 53.85% of these cases. In 15.38%, follicular expansion > 3mm was observed. SNCs were associated with other SNT in only four patients. CONCLUSIONS: Despite of the fact that the SNCs are usually diagnosed casually in the course of radiological exploration, in the present study over half of them (53.85%) caused impaction of the permanent canine. Early diagnosis allows optimal patient management and treatment planning, with intervention at an appropriate time to prevent complications in development and so reduce later treatment need.